BU Brain Researchers Grapple with NFL Offer

League proposes $1 million for concussion research

Robert Stern, a codirector of BU’s Center for the Study of Traumatic Encephalopathy, says he was shocked when the NFL offered CSTE $1 million to research the impact of concussions. Photo by Vernon Doucette

Sunday afternoons have felt different for football fans lately, thanks in no small part to researchers at BU.

A dramatic shift has altered the NFL culture over the past few months: rule changes, TV commentators pointing out dangerous hits, public service announcements about concussions, and star quarterbacks ordered to sit out important games after blows to the head. This stunning mid-season transformation has evolved from research at BU’s Center for the Study of Traumatic Encephalopathy (CSTE) linking concussions to later-life brain disease.

In the past, the league cast doubt on CSTE’s claims and insisted it would conduct its own studies. But in the face of overwhelming scientific evidence, U.S. congressional hearings last October, and a slew of bad press, the NFL last month offered $1 million — or more — to fund CSTE’s work.

BU Today caught up with CSTE codirector Robert Stern, a School of Medicine associate professor of neurology and codirector of the Alzheimer’s Disease Center’s Clinical and Research Program, to ask about the ethical considerations of taking money from the NFL to study what has become its gravest liability in terms of athletes’ health, as well as public relations: head trauma.

BU Today: What was your initial reaction to the NFL’s offer?Stern: I was quite shocked. Dr. Robert Cantu, one of our codirectors, had been having high-level meetings with the NFL about their wish to support our research by encouraging current and retired players to serve as brain donors, as well as some rules changes they’ve been making. We’ve been in close touch, but never had money been mentioned.

This from the same folks who once tried to discredit you?Not discredit, but they cast doubt on the link between repetitive head trauma and later-life disease. They weren’t our fans, and we weren’t necessarily their fans. However, since the October congressional hearings, they’ve been making some unbelievable changes in dealing with the health of their players. For example, the two cochairs of their mild traumatic brain injury committee were forced to resign. One of them refused to acknowledge the link between head trauma and disease.

Also, there have been unprecedented mid-season rule changes. Players showing any sign of concussion cannot return to play that day, whether to a game, or more strikingly, a practice. And there has to be an independent neurological specialist appointed for each team to diagnose and make decisions about return to play. To have Pittsburgh Steelers quarterback Ben Roethlisberger and Arizona Cardinals quarterback Kurt Warner both sit out a game in a critical time of the season because of concussions would never have happened before. These are the two Superbowl quarterbacks from last year. There’s still a huge need for more change, more awareness, and more research.

Under what conditions, if any, would CSTE accept the NFL’s money?There’s nothing formal proposed yet. We’ve made it clear that the only way we could discuss the possibility would be if there were no strings attached, an unrestricted donation that would be free of any real or perceived conflict of interest. The most important thing is that we retain our complete independence and maintain terrific vigor in our research. As long as the wording is such that the donors don’t have any say in the research, its interpretation, and publication of the results, then that makes it kosher.

What would a million dollars mean to your research?It sounds like a lot of money, but this research is quite expensive. It would allow us to continue to examine the brains of deceased athletes, expand our infrastructure, expand our pilot data collection for clinical studies such as neuroimaging and cerebrospinal fluid measuring for proteins. It wouldn’t necessarily allow us to do a major study, because research is much more expensive than that. But it would be a tremendous shot in the arm.

What are your funding sources?Three basic sources: one was start-up money from BU’s School of Medicine, as well as individual departments across MED, the School of Public Health, and the Veterans Affairs Medical Center. We also obtained two grants from the National Institute on Aging as supplements to our NIA-funded Alzheimer’s Disease Center. Finally, we received a two-year grant from the National Operating Committee for Standards in Athletic Equipment (NOCSAE). The federal money thus far is around $200,000 and from NOCSAE it’s around $250,000. I’m in the midst of writing a grant for the National Institutes of Health, which is millions of dollars, to do an in-depth clinical study of chronic traumatic encephalopathy (CTE).

Are you looking to historical precedents as you consider forging a financial relationship with a one-time nemesis? The analogy is the tobacco companies. Big Tobacco was funding research in the ’60s and ’70s, and because of their funding there was lots of conflict of interest about the results and how they could be interpreted.

Concussion is — quote — a no-brainer. The more times you hit your head, the more likely there is to be something wrong in the future. We just want to find out what the specifics are and how to cure and prevent it.

6 Commentson BU Brain Researchers Grapple with NFL Offer

The Boston University Faculty Council will today be reviewing the draft of a proposed new policy on Institutional Conflict of Interest in Research. This is not regarding whether the researchers have a financial stake in the outcome (a different policy). The new policy is for regulating situations where Boston University or key decision-making individuals have a real or perceived interest in influencing the acceptance and/or outcome of research (sharing ownership in a startup company, avoiding institutional embarrassment, seeking institutional publicity, or whatever). It is hard to craft such a policy, and one issue is whether to just set up mechanisms, or also to give examples. Your Faculty Council representative(s) will be engaging this issue this afternoon.

The NFL’s past concussion research has been such a farce and a documented fabrication, they should not be allowed in. By doing so you taint the entire purpose of the research, independence. If they are allowed in, their shadow will minimize the significance by their very involvement. These are the owners of the NFL, players are interchangable pieces of meat, let them come up with their own creative ideas, better equiptment for one.

His last season he had suffered his 2nd GRADE 3 CONCUSSION in a 11 month period.

He was being told that if he got one more concussion, he would never be able to play sports again. I started to do major research on concussions and mouth guards when I came across your website. My son was fitted for a Maher mouth guard right before the football season begun. In the first game he was hit very hard and as a mom.I was holding my breath to see if he had to come out of the game. He got right up and continued playing. After the game I asked him about that hit and he said “Mom I can’t believe I didn’t feel a thing”

Which ,as the season continued, he said it has helped unbelievable! I have parents coming to talk to me when their child gets a concussion to see what I have learned and what steps for protection I have taken. I truly believe that the Maher mouth guard is 100% the reason my son can continue to play sports. Thank you!

The blood has already been spilled, partnering with the NFL without critisizing their past research manipulations and fabrications, puts the blood on B.U.’s hands. A full analysis of NFL concussion committee research must be done, in order to expose these studies that have been called into question. Like big tobbacco they were done to minimize the effects of concussion in order to stall and reduce any legal liability claims against the NFL. To fund a study where brains will be harvested and tested over the next decade or maybe longer, falls right into the NFL’s plan, calling into question the credibility of B.U. This institutionalized stall is classic NFL, enabling them, is not worth the trouble. The medical community has already proven in boxers, CTE and other problems occur from repeated blows to the head, jaw, and upper spine. Locating the mechanism which causes this problem is more important. Protecting players today, preventing future CTE cases should be the focus.

I’m very grateful to see that the research is being given the funding to explore this issue.
Something that I’ve been noticing, in both college and pro football, is the amount of players that seem to lose their helmets during games. I’ve been watching this sport on many levels over the past few decades and don’t remember a time when I’ve ever seen it happen so often…one comes off almost once a QUARTER! My question is, does this have an effect on the amount of concussions were seeing? My guess is, yes it does. We’re seeing more players with dreadlocked/longer hair, which could be a problem, as well as loose and ill fitting equipment. Most of these teams are using the top equipment available and it’s up to the organizations and players to use them properly.
The issue that I’m more concerned with are the younger generations of players that look up to these professionals and want to model themselves after their idols. High school individuals that are putting their young lives in jeopardy to achieve that “look” that their heroes have, but don’t understand the risks that their taking. Some of these youngsters may not even have Health Insurance and risk, besides their health, their parents financial well-being all for the sake of fashion.

The NFL has a clear conflict of interest, since they want to minimize liability. To this end, the grant to BU can well be used as evidence that the NFL is following best practices (as defined by the grant recipients) and is diligent in protecting players from harm. On the other hand, the NFL also has a clearly ethical motive, since they have the greatest financial interest in protecting players (their assets). The $1million grant is very valuable to advance the science since there are many open questions on how best to treat and prevent brain damage from game injuries: Which injuries require treatment? How long should a player be removed from play after injury? What physical treatments and brain supplements are required for short- and long-term treatment? What helmet technology should be required by the NFL that will not interfere with the game? Because of the NFL funding, there will always be an implied asterisk next to the research findings, but the research is so important that BU should accept the grant while clearly acknowledging the conflict of interest.